Tuesday, March 11, 2008

A SHOUT FROM COPENHAGEN: PAIN.

This starts with me, but it is not about me. It is about pain. The pain of hurting and the not knowing why you hurt. Or knowing why and the reason making it worse.

I have lived a life in which I never thought much about my health. I eat and drink as I please, exercise a bit, mostly don’t smoke anymore but for an occasional cigar, have had no real health problems and, aside from the occasional tooth ache and a bout of indignity with a urologist a while back, very little pain.

This past Sunday I woke at 5:28 a.m. It was my 64th birthday, and I’d invited Lady Alice and my kids and son-in-law out for a birthday lunch. But the clock was set for 6:30 and it was only 5:28. Something else had awakened me.

Pain. In my side. Bad pain. Very bad. Appendicitis? I limped out to my computer, googled “appendicitis.” Right side. This was the left. And escalating. I limped around the apartment, groaning like an old man, instructing myself not to act like a baby, thinking, God has decided to cut me down on my 64th birthday! Which somehow seemed ironic and vaguely funny, though the pain would not allow me to laugh. There was a basic background of excruciating pain which every so often would notch up and remain at the new level.

Pain this great, I thought, cannot continue for long. It continued. Half an hour. Forty-five minutes. An hour. I leaned on a chair back, bowed forward across the surface of the dining table, knelt on the floor with my butt in the air and my chest on a cushion, lay on my right side, left side. Nothing helped.

I tried to think. What to do? Emergency room? Call the emergency doctor? What’s the number? But my brain was taken up by the pain, no room for thought, trying to fathom it. Without success. Abstract from it. Can’t. Now it was an hour and fifteen minutes, and the pain still constant and very bad. On a scale of 1 to 10? This has its own scale which outweighs all normal measures. Here there’s only max.

You baby! Pull yourself together! Can’t. Why do I hurt so bad?

As the pain moved toward an hour and a half’s duration, I went back in to the bedroom and woke Alice. I said, “Honey, I need your help.”

Within a minute, she was on the phone calling the emergency doctor. There was a queue on the line, and we were told by a recorded voice that we were number fourteen. Which meant a good hour before we got through and then no doubt three or four or five hours before the doctor came. Alice called the hospital emergency room to ask for an ambulance, was told we should take a taxi out, so she called for a cab and was promised one in ten minutes.

At which point I ran for the bathroom and heaved. Twice. Red. Blood? I thought of my father who at 58 one day threw up blood, lived on in terrible pain for three days, then died. My heart went out to him for those three days of pain. Here I was not quite at two hours and almost willing to die to be free of it.

Meanwhile Alice cancelled the taxi and called back to demand an ambulance. They were there in less than ten minutes. Two young men. The one said to me, “Boy, some birthday present, huh?”

They drove me to the trauma center at Rigshospitalet – the hospital made famous by Lars Van Trier in his TV series Riget, later optioned by Stephen King as The Kingdom, although King could never touch Van Trier in terms of intelligent eerie dark humor.

The details of what happened at the trauma center are not interesting – other than to say that everyone was enormously kind and that finally, to put an anticlimax on it, I learned that the pain was probably due to the passing of a kidney stone. So, nothing fatal. Curfew would not ring for me that day. But what did interest me about the whole experience – aside from the confirmation that, despite complaints to the contrary, the Danish health care system seems to me to function extremely well and the confirmation of the great good fortune of modern medicine as well as of having someone who loves you and will stand by you in need (to be more specific my great fortune at having Lady Alice by my side!) – was what it taught me about pain.

I had never known pain like that before and for the four unbroken hours (four hours and 20 minutes to be exact) that it continued, it occupied me constantly. The only relief I found came via my mind and my emotions – the relief of thinking about and empathizing with everyone I know who had experienced pain – my father in his three days of dying, my friend Susan and my former student Cindy who had battled cancer for their lives and won, my oldest brother who’d endured holes being drilled into his skull, my son who was in pain after an operation and denied the additional morphine he requested, my friend David who’d had his breast bone sawed and pried open to have a new valve installed in his heart, my mother who just before she went into her final paroxysm said, “I’ve never had such a headache before,” which I suddenly understood to have been pain of extremely great magnitude.

And I thought of the torture victims whose stories I know via Inge Genefke and the torture rehabilitation center organizations here and whose pain was not only as bad as what I was experiencing but far far worse and further amplified and complicated by the fact that it was being caused intentionally by other human beings in order to promote their suffering and to try to eradicate their personalities with pain. With my intellect I could see how much worse that was, and although it did not alleviate my own pain, it gave some degree of comfort for me to be able to feel a rending compassion for those suffering souls in their lonely torment.

When one of the hospital orderlies told me that the pain I was experiencing was said to be similar to the pain of a woman in childbirth, this did not have the same effect on me. Because, although I have respect and compassion for women in the pain of childbirth – indeed am awed by their ordeal, I can not help but feel that it must alleviate the pain to know that it is leading to the delivery of a new life into the world. Torture victims must have an almost exactly opposite impression of their pain, their degradation; that it serves no good, on the contrary. I think about the fact that today, the day after, I ache in all the muscles of my chest, in my pleura, the muscles of my back – because I was literally writhing with pain for four hours. What after-affects – sequelae – do torture victims experience, both physical and psychological? It does not bear contemplating. The vast majority of us will never know anything of that kind of hell of pain.

And my own pain yesterday was in a sense, in the words of the ambulance attendant, a birthday gift of sorts. Because it opened a part of my mind and taught me something.

It taught me that pain is another dimension. It gave me a glimpse of what it is like for anyone stuck in that dimension and made me understand, graphically, the need for empathy. And it made something else quite clear to me: I do not wish to visit that dimension again anytime soon.

Still, the end awaits us, and we do not know what path will take us to it. And as Sophocles put it, in one of the greatest scraps of dark humor of all time, “Count no man happy until he is laid in his grave.”